Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Deloha Zimmerman
390 Southeast Monroe
Krebs, Oklahoma 74554
Policy # 815-520-286


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.25
    $625.00
  2. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.25
    $625.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  4. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 Eastbound @ MM 249 - Henryetta, OK

Subtotal $1,400.00
Total Due $1,400.00


Updated
July 12, 2021 @ 5:39 pm

Invoice updated by Geoffrey.

Status Update
July 12, 2021 @ 5:39 pm

Status changed: Draft to Pending.